Am I just a fat, lazy hypochondriac????

[OpheliaBumps]

Afternoon

Would any of you mind giving me your opinions please?

For over a year and especially over the last few months I've had what could be hypo symptoms (but from what I've read could also be symptoms of vitamin and iron deficiencies). Went to my GP who, as most of you have found, couldn't have been less interested! She agreed to me getting basic bloods done and, once those results were back, very very reluctantly agreed to doing TPO, Free T3 and Free T4 levels. I'm a nurse so got my bloods done at work and am also able to access (probably unofficially) my results so wasn't going to be fobbed off with the usual 'all normal' response.

SYMPTOMS

weight gain and real difficulty losing anything, fatigue/lethargy/lack of motivation, depression (being treated with sertraline for 3 years), recurrent colds which always result in losing my voice for weeks, restless/light sleep, mild carpal tunnel, stiff fingers and toes, nails that break and peel, restless legs, scalloped tongue, always too hot with random sweats, loose stools, pitting oedema lower legs (bit of an odd one!)...........

BLOOD RESULTS

TSH 3.29 (0.3 - 4.2)

Free T4 11.4 (9 - 19)

Free T3 4.3 (2.6 - 5.7)

B12 221 (180 - 900)

Folate 5.5 (3 - 20)

Ferritin 62.8 (10 - 200)

Total Cholesterol 5.5 (<5)

CRP 14.2 (0 - 5)

WCC 12.8 (4 - 11)

Do I have a problem or am I just a fat, lazy hypochondriac??????

[SeasideSusie Remembering]

OpheliaBumps Well your GP might think you are a fat, lazy hypochondriac but, in fact, you have as problem.

TSH 3.29 (0.3 - 4.2)

Free T4 11.4 (9 - 19)

Free T3 4.3 (2.6 - 5.7)

A normal healthy person would probably have a TSH less than 2, FT4 around mid range. Your FT3 is reasonable because your body is doing it's best at the moment to push out as much of the active hormone (T3) as possible. In some countries you would have a diagnosis of hypothyroidism with your TSH, here they like to wait until it reaches 10

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Did you have antibodies tested? What was the result?

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B12 221 (180 - 900)

Folate 5.5 (3 - 20)

Way too low to be healthy. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... If so please post on the Pernicious Anaemia Society forum here on Health Unlocked for further advice. Quote these results, any signs of deficiency, plus your ferritin and any other iron results you may have healthunlocked.com/pasoc

If no signs of deficiency then your B12 is far too low and your Folate is very low, it should be at least half way through it's range.

I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:

"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."

And an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

That's good enough for me and I keep mine around 1000. Sublingual methylcobalamin lozenges are what's needed to supplement B12 yourself (5000mcg daily to start, then when the bottle is finished change to 1000mcg daily as a maintenance dose) along with a good B Complex to balance all the B vitamins and help raise folate level (buy one with methylfolate rather than folic acid).

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Ferritin 62.8 (10 - 200)

Ferritin should be half way through it's range with an absolute minimum of 70 for thyroid hormone to work - and that is our own as well as replacement hormone.

With your level I'd be inclined to eat liver regularly, maximum 200g per week due to it's high Vit A content, and eat lots of iron rich foods apjcn.nhri.org.tw/server/in... and that will be far easier than faffing about with iron tablets and risking constipation and stomach upset, and keeping it away from other supplements and medication by at least two hours.

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Total Cholesterol 5.5 (<5)

Raised cholesterol can be a sign of hypothyroidism. It should settle when treated.

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CRP 14.2 (0 - 5)

You might know this is an inflammation marker. Maybe you had inflammation or infection at the time of the test.

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WCC 12.8 (4 - 11)

This could indicate increased production of white blood cells to fight an infection.

[OpheliaBumps in reply to SeasideSusie]

Thanks SeasideSusie I was thinking a lot of the same things but it's so easy to doubt yourself and think you're making a fuss about nothing when you get so used to your symptoms!

I did get TPO tested and it was <35 with normal being <60. Is it likely that correcting the B12, folate and ferritin will improve thyroid function??

I do have B12 deficiency symptoms and, having spent hours when I've been too tired to do anything reading posts on the PA forum, I posted the same message there for advice. I've ordered the Jarrows 5000mcg methylcobalamin as well as methyfolate 400mcg supplements (not sure how much of the methylfolate to take though was thinking 800 - 1600mcg/day?). While I know it's unrealistic I'm really hoping for a quick improvement with the supplements - the weight gain, lack of energy and general aches and pains are making me so bloody miserable!

Not the biggest fan of liver so googling (how did I ever live without google??) for a gentle on the guts form of iron although again, not sure how much to take - any suggestions?

[SeasideSusie Remembering in reply to OpheliaBumps]

OpheliaBumps - I raised my folate from very bottom to very top of range within 2.5 months by taking Thorne Basic B which contains 400mcg methylfolate along with the other B vitamins needed to keep everything in balance when taking B12.

BUT as you have signs of B12 deficiency then take the advice of the PA forum before doing anything else. You may need testing for Pernicious Anaemia, you may need B12 injections. Don't supplement anything until you've had their advice and you may need to discuss it with your GP.

I was a demi-veggie for donkeys years, hadn't eaten red meat just chicken and fish. However, for me it was needs must and I now eat liver regularly and it's done a very good job.

A gentle form of iron supplement is Solgar Gentle Iron or any other Iron Bisglycinate as long as it is Albion Ferrochel (eg healthmonthly.co.uk/swanson... )

These contain much less elemental iron that something like ferrous fumarate so you may find you need to take more. You could start with one and see how it goes. Don't forget to take each one with 1000mg Vit C to aid absorption and help prevent constipation, and iron must be taken at least two hours away from any other medication and supplements. You also need to retest so you stay around the halfway mark in the range.

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Optimal levels of all vitamins and minerals, particularly ferritin, should help. Also supplementing Selenium helps with conversion of T4 to T3, recommended is selenium l-selenomethionine at 200mcg daily.

[jgelliss]

OpheliaBumps I'm so sorry your going through all the hypo symptoms . It's very important and great that you journaled your symptoms . It's very important to trust yourself . SeasideSusie is very well informed with our nutrients that help our thyroid meds to work optimally. A lot of us forget that thyroid meds alone don't work as well as it can without the nutrients .Raising the nutrients to the levels that we need makes a big difference . For example I had anxiety and palpitations and cold most of the times when others where comfortable . After running labs with full iron panel and ferritin my ferritin was very low and raising my iron levels helped with my issues . I hope your issues get resolved ASAP.